They’re trying to block patients from coming to Planned Parenthood. However, the latest attack is much bigger than Planned Parenthood. This new rule would be radical departure from the way health care has operated in the United States up until now.

On Tuesday, May 22nd, at a reception for the Susan B. Anthony List, an organization known for their extreme anti-choice agenda, President Donald Trump announced he would be making changes to a decades-old federal family planning program, Title X. The changes are a gag rule. Period.

The gag rule would do four main things.

1. Impose new rules designed to make it impossible for patients to get birth control or preventive care from reproductive health care providers like Planned Parenthood.

2. Prevent health care providers across the country — including doctors, nurses, hospitals, and community health centers — from referring their patients for safe, legal abortion.

3. Remove the guarantee that patients get full and accurate information about their health care from their doctors.

4. Remove the requirement that contraception be medically approved and that providers ensure access to full range of birth control.

This is a direct attack on women’s basic rights.

Established in 1970, Title X is the only federal grant program dedicated solely to providing individuals with low incomes access to comprehensive family planning. Title X ensures people have access to contraception and gives them more control over their lives, health, careers, and economic security.

In Illinois, there are 95 Title X sites, 17 of which are Planned Parenthood of Illinois (PPIL) health centers. While PPIL makes up only 18% of total Title X providers in the state, PPIL serves 42%, or 43,950, of Title X patients in Illinois. Blocking patients from going to Planned Parenthood means that many of these people would go without care because Planned Parenthood is the only Title X health care provider in their community. In Illinois, there are six counties—LaSalle, Macon, McLean, Peoria, Sangamon, and Tazewell—where PPIL is the only Title X provider.

It gets much worse. Nationally, there are 4,000 Title X health centers, and this gag rule would block federal funding from going to any US health clinic that so much as mentions abortion as an option for women. This means that many community health centers, hospital-based clinics, and health departments would also be gagged from giving patients full and accurate information about all of their options.

This is detrimental for the state of Illinois.

If Planned Parenthood were excluded from Title X, all other types of Title X-funded sites in Illinois would have to increase their contraceptive client caseloads by 73 percent to serve the women who currently obtain contraceptive care from Planned Parenthood health centers. For example, in DuPage County, PPIL’s Aurora Health Center serves 75% of patients that access contraceptive care from a publicly funded health center.

This gag rule would fall the hardest on people of color.

Because of systemic inequities, many patients who rely on Title X for their health care needs are people of color, who already face significant barriers to accessing health care. About 21 percent of Title X patients identify as Black or African American and 32 percent identify as Hispanic or Latino. After being blocked from these health centers, including Planned Parenthood, many patients would have nowhere else to go for care.

How can you fight back?

The proposed rule was officially published in the Federal Register on Friday, June 1. The 60-day comment period is open now and will conclude on July 31.

Senate Republicans have passed their tax bill, and the President has dubbed it an historic moment. Here are words I never imagined I’d say: He’s right. Because this is a historically bad bill: not just the most unpopular tax legislation in forty years, not just the most brazen federal boon to billionaires in modern memory, but the first ever so-called tax bill to strip 13 million Americans of their health insurance.

Currently, the GOP’s stealth attack on Obamacare appears only in the Senate bill, not in the one passed by the House. In coming weeks, the House and the Senate will combine their bills into a version they both agree on. If Republicans in Congress manage to jam repeal into this final bill, history won’t just be made, it will be repeated. The President and his party will throw the country back into a time when too many Americans could not access the medical treatment that would save their lives.

We’ve been framing the tax debate as a question of economics: Should we strip the middle-class of crucial deductions to put more money in the hands of corporate investors? Should we sacrifice the future of Medicare and other essential social service programs to save the President’s family business a few (million) bucks? Should we blow up the federal deficit and trigger catastrophic spending cuts? (The GOP’s response: yes, absolutely, and sure, why not?)

Here’s the question we should be asking: If this bill passes, will it be harder for me to protect my health and the health of the people I love?

The answer: another resounding yes. The Republicans in congress have smuggled a time bomb into their bill, and when it goes off, it will explode our individual health insurance system.

Back in July, the Senate voted down a “skinny repeal” of the Affordable Care Act. The centerpiece of that effort was the elimination of the “individual mandate,” a requirement that anyone who can afford to purchase insurance does so. This may sound like a minor change. It would in fact be catastrophic.

As a policy advisor in Obama’s Department of Health and Human Services, I helped roll out many of the reforms within the ACA. In the process, I came to understand that a stable market depends on both the sick and the healthy buying insurance , which means without the mandate, the whole system falls apart. There’s good reason the American Medical Association, the AARP, the American Cancer Society Action Network, and a bipartisan group of governors all rallied against skinny repeal. They believed it would put millions of Americans at risk.

They were right.

Senate Republicans have tried again and again to repeal Obamacare. Again, and again, they’ve failed. They failed because we, the people they represent, want affordable access to health care, and we made our voices heard. Now congressional Republicans have resurrected skinny repeal from the dead and slapped a new name on it. Under the guise of a tax bill, they’re trying yet again to abolish the individual mandate, hoping this time, no one will notice.

They think they can get away with this because the mandate itself isn’t popular. No one likes being told what to do, much less what to buy. But when healthy people aren’t required to buy insurance, fewer of them do. This leaves behind a higher percentage of sick people in the insurance market , which raises costs for the insurance companies. So, insurers shift these costs to consumers, and everyone’s rates rise. When they do, this drives even more people out of the market, and the market edges closer to collapse. Here comes the GOP’s favorite part: The fewer people who can afford to buy even subsidized insurance, the less money the government must pay out.

The nonpartisan Congressional Budget Office estimates that one year after repeal, 4 million fewer people would have health insurance. By 2027, that number rises to 13 million. Those remaining on the individual market will pay 10% higher rates every year — and that’s in the lucky state markets that survive. Meanwhile, the government nets $338 billion to pay for its corporate tax cuts. Or, I should say, to pay for a fraction of its corporate tax cuts, keeping their cost to a mere $1.5 trillion.

To be clear: The GOP isn’t denying this. They’re counting on it. If 13 million people don’t lose access to health care, congressional Republicans don’t get their $338 billion.

You don’t have to be on the individual insurance market to bear the burden of its destruction. When uninsured people get sick, they’re legally entitled to emergency care — and someone must pay for it. A portion of that cost falls on hospitals, which could be forced to close their doors. A portion of the cost falls on insurers, who could compensate by raising your rates. And the remaining billions of that cost will fall directly on the American taxpayer — you.

Then, of course, there’s the human cost. As a registered nurse, I know all too well what happens when a cancer patient can’t afford chemotherapy, when a cardiac patient can’t afford a new defibrillator battery, when a diabetic patient can’t afford insulin. For many Americans, this tax bill could be a death sentence — and that’s a higher cost than any of us should be willing to pay.

The Republicans in congress can call it whatever they’d like, but this is not tax reform. This is health care repeal. This is a stealthy slashing of the social safety net. And this is all for the sake of income redistribution — shifting ever more money from the poor and middle-class to the rich. It’s fiscally irresponsible and morally bankrupt.

Affordable health care can still be saved — but only if enough House Republicans stand up to their party, their President, and their wealthy donors. Unfortunately, congressional Republicans don’t seem to mind that their constituents hate this bill, as long as those donors love it.

The billionaires who fund the Republican Party have made themselves clear: give us our tax break, or the donations dry up. By supporting this bill, our representatives have in turn sent us a very straightforward message: We don’t care about you, unless you’re in the top 1%. We don’t care that the ballooning deficit could trigger billions in automatic cuts to programs like Medicare, the Student Loan Administration, and the Military Retirement Fund. We don’t care that your taxes might actually go up, or that your state and local budgets might be gutted. And we certainly don’t care about your health.

A vote for this bill says: We only care about the wealthy donors who fund our campaigns. We only represent them.

Anyone willing to say that should lose their privilege to represent us.

Lauren Underwood is a registered nurse, health policy expert and former Senior Policy Advisor in the US Department of Health and Human Services. She’s running for Congress in Illinois’s 14th Congressional District against Tea Party Republican, Randy Hultgren, who voted to support the House Tax Plan.

In late September, the Affordable Care Act (ACA) survived yet another repeal attempt by the U.S. Senate. However, every time this happens, there is a tendency for supporters of the ACA to take a deep breath, celebrate the moment of victory, and then place that win on the back burner of our collective memory and attention. We do this primarily because there is a continuing assault of Category 5 storms to weaken or destroy federal agencies, the social order, the world order, and the democratic system of government that we have come to know and cherish over the past 240 years.

So let me be crystal clear—the assault on the ACA continues daily in D.C., and each health care battle is only a handful of confetti in the ticker tape parade that Trump imagines in his reality TV show, “The President.”

Here are the most recent items, as reported in the Washington Post .

Conservative Iowa sought permission from Health and Human Services (HHS) to revitalize their health insurance market. Insiders reported that Trump instructed the director of HHS to tell Iowa No in an effort to undermine the ACA, even if it means hampering state efforts to keep premiums low.

HHS is trying hard to suppress the number to enroll in the upcoming open enrollment period, November 1–December 15, 2017. It has cut the enrollment time in half and reduced the advertising budget from $100M spent last year to $10M. Scratching my head as I type, I can say I have seen absolutely no TV ads on the open enrollment this year. HHS also has told regional administrators not to even meet with on-the-ground, grassroots organizations about enrollment.

On October 6, Trump directed a long-awaited revision to the ACA requirement that most employers cover birth control as preventive care for women. Under Obama, this applied to all FDA-approved methods, and most women no longer had to pay for contraception. However, Trump repealed this requirement, effective immediately, to allow employers to opt out of the mandate to their health plans, by claiming “religious or moral objections.”

On October 12, the Trump administration announced it will end subsidies to health insurance companies designed to help low-income people with premium costs and out-of-pocket medical costs.

Also on October 12, HHS approved sales of cheaper plans that provide fewer benefits and weaker protections, aimed at younger, healthier consumers. This will explode the cost of stronger plans necessary for those who need better, ongoing coverage.

Trump, Pence, and administration officials continue to beat their drum loudly that the ACA is failing, while not even sub rosa, they continue to do an “Et tu, Brute?” attack on it. In addition, the proposed tax plan/tax cuts to the wealthy will precipitate further cuts to Medicaid, Medicare, and even Social Security with the argument that they need to “cut these expenses” in the federal budget. Eventually more than the ACA will be shredded.

Americans’ health care and their health will disintegrate from these tactics, and the members of Congress who stand silent are complicit in the fallout from the actions of Trump & Co.

At the same time, the voices for single payer, Medicare-for-all grow stronger, louder.

It seems the chasm between the Right and Left of our country continues to widen.

ACE Leader Beverly George also is a member of Indivisible, the Naperville League of Women Voters, and the Citizens Climate Lobby. She also volunteers with her parish PADS group. A former chemist, George worked in clinical chemistry and hematology research at the Centers for Disease Control for six years and taught chemistry and freshman science at Naperville North High School for 20 years.

Having spent the weekend looking into the newly released (on Thursday) plan for “health care” for Americans who need these benefits the most, I can’t bring myself to call it the GOP’s “Health Care Plan,” because it has literally nothing to do with health nor with the care for others.

The GOP’s “American Health Care Act” (as it was known in the House); or the proposed “Better Care Reconciliation Act of 2017,” (as it is identified in the Senate), should be an embarrassment to any legislator who signs this repugnant piece of legislation.

While the Affordable Care Act (ACA) is not perfect, it allows for important consumer protections for every American, including the following:

• Coverage of health benefits including ambulatory, hospitalization, emergency services, maternity and newborn services, mental health services, prescription drugs, rehabilitation, laboratory services, preventive/wellness services, and pediatric services, including dental and vision.
• No lifetime maximums.
• No annual maximums.
• No denials for pre-existing conditions.
• Guaranteed renewals.
• Insurance premiums based solely on age and geographic location.
• Insuring children to the age of 26.
• The right to an external appeals process.

The Republican plan is not at all about “health care.” It’s a smash and grab of a pile of cash, currently set aside to assist the poorest among us (elderly, children, and the disabled).

The long-term goal of the GOP plan is to pass a massive tax cut for the very wealthiest Americans by utilizing the budget reconciliation process of the federal government (a system which is allowed only once per fiscal year). The repeal of the ACA would fall into fiscal year 2017, and the tax reform section (cutting taxes for the ultra rich), would fall into fiscal year 2018. So, instead of being about “health care” at all, the actual health care cuts under the GOP plan are being used to balance the long-term federal budget (under the Byrd Rule). And that is, in part, why it will take seven years, they say, to roll out. In order for it to be legal, this process must be included in a “long-term budget.”

‘The GOP plan is nothing more than a cash grab. Easy money taken away from people who have no voice.’

“The Byrd Rule is a set of limitations on the (budget) reconciliation process, which can allow the Senate to pass legislation with a simple majority,” according to the Committee for a Responsible Federal Budget. And who has the majority in the Senate in 2017? The rule was championed by former Senator Robert Byrd (D-WV) and established in Section 313 of the Budget Act. The rule “disallows ‘extraneous matter’ from being included in a (budget) reconciliation bill … extraneous matter being defined in three major categories of restrictions.” For more on the Byrd Rule, click here.

It’s a reverse Robin Hood. Grab cash from the poor (in the form of the health care dollars formerly put aside for them plus severe cuts to Medicaid funding) and give it to the very rich (in the form of tax breaks). It is all very legal. It’s just not the right or moral thing to do.

For the ostriches who stick their heads in the sand and think, “It won’t affect me! I have good insurance through my employer,” you know someone this crisis will affect. In Naperville alone, if you live in House District 6, Peter Roskam’s (R) district, 61,000 people are set to lose benefits. If you live in House District 11, Bill Foster’s (D) district, 58,000 people will lose benefits. It will affect your neighbors.

Senators come from all walks of life. I get that. I get that many won’t bother to read or to understand this vitally important bill. It’s a shame. It’s a painful pill to swallow. Because if they would read and digest this bill, they would clearly see what I’ve seen. The GOP plan is nothing more than a cash grab. Easy money taken away from people who have no voice. This bill is sick. It’s amoral. And those who have a voice must educate friends, neighbors and senators about what is at stake.

Former NBC5 traffic reporter and radio personality Dawn DeSart is a precinct committeeperson for the Wheatland Township Democrats. She also has served on the Indian Prairie School District’s Board of Education, and on the boards of the Fox Valley United Way and Little Blessings Preschool.